Document Detail


Cardiac functional reserve is diminished in growth hormone-deficient adults.
MedLine Citation:
PMID:  19207478     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Various studies have shown that patients with severe growth hormone deficiency (GHD) have diverse changes in left ventricular (LV) size or performance but so far there is no direct indication of cardiac reserve ability to maintain the circulation during peak exercise. We tested the hypothesis that patients with severe GHD have reduced cardiac reserve function compared with healthy controls. Eighteen patients with severe GHD were studied and compared with 18 age-, sex-, and body mass index (BMI)-matched healthy controls. Peak cardiac power and cardiorespiratory fitness were investigated using noninvasive hemodynamic measurements during maximal cardiopulmonary exercise testing. Compared with matched controls, the cardiac power of GHD patients during exercise to volitional exhaustion was significantly reduced by 15% (mean +/- SD: 4.4 +/- 1.0 watts (W) vs. 5.2 +/- 1.0 W, P= 0.02), despite attaining similar aerobic exercise peaks (VO(2max), GHD: 2390 +/- 822 mL/min vs. controls: 2461 +/- 872 mL/min, P= 0.80) and similar peak respiratory exchange ratios. The lower peak cardiac power could not be accounted for by peripheral alterations because both groups reached similar peak exercise systemic vascular resistances. Patients with GHD also had lower cardiac chronotropic reserve (peak heart rate: 154 +/- 21 bpm vs. 174 +/- 11 bpm, P= 0.001) and a lower cardiac pressure-generating capacity (systolic blood pressure [SBP] 160 +/- 25 mmHg vs. 200 +/- 15 mmHg, P < 0.0001). Using this robust noninvasive method of assessing functional cardiac pumping capacity we have for the first time shown that patients with severe GHD have a significantly impaired cardiac functional reserve associated with chronotropic incompetence and impaired pressure-generating capacity.
Authors:
Robert Moisey; Steve Orme; Diane Barker; Nigel Lewis; Lisa Sharp; Richard E Clements; David F Goldspink; Lip-Bun Tan
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Cardiovascular therapeutics     Volume:  27     ISSN:  1755-5914     ISO Abbreviation:  -     Publication Date:  2009  
Date Detail:
Created Date:  2009-02-11     Completed Date:  2009-03-26     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101319630     Medline TA:  Cardiovasc Ther     Country:  England    
Other Details:
Languages:  eng     Pagination:  34-41     Citation Subset:  IM    
Affiliation:
Department of Endocrinology, Leeds General Infirmary, Leeds, United Kingdom.
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MeSH Terms
Descriptor/Qualifier:
Absorptiometry, Photon
Adult
Blood Pressure
Body Size
Case-Control Studies
Exercise Test
Exercise Tolerance*
Female
Heart Rate
Hemodynamics*
Human Growth Hormone / deficiency*,  therapeutic use
Humans
Hypopituitarism / drug therapy,  metabolism,  physiopathology*
Insulin-Like Growth Factor I / metabolism
Male
Middle Aged
Myocardial Contraction*
Oxygen Consumption
Recombinant Proteins / therapeutic use
Vascular Resistance
Chemical
Reg. No./Substance:
0/Recombinant Proteins; 12629-01-5/Human Growth Hormone; 67763-96-6/Insulin-Like Growth Factor I

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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